There are nearly 56 million abortions every year in the world and almost half of them are unsafe, according to a major piece of research from the World Health Organisation (WHO).

The study found that there were 55.7 million abortions every year between 2010 and 2014 worldwide, and of them 17.1 million were unsafe because the woman was taking pills alone or was with a trained helper but using a method of abortion that is no longer considered best practice.

But a further 8 million abortions, categorised as “least safe” in the study, involved desperate and dangerous backstreet measures, from swallowing toxic substances to inserting wires to try to bring about a miscarriage.

The highest levels of unsafe abortions were in Africa, where only about one in four are safe and as a result abortion deaths are high.

The new figures, from the WHO with the Guttmacher Institute, are published in The Lancet medical journal at a time when international family planning organisations are deeply concerned over cuts to their budgets announced by the Trump administration in the US.

Experts say the proposed cuts, together with the reimposition of the restrictive Mexico City policy (also known as the Global Gag rule) which forbids US federal funds to any organisation that counsels women on abortion, can only make things worse.

The study finds that there are fewer abortions in places where abortion is safest, such as in northern Europe and northern America where women can get contraception easily. The authors explain that most countries in those two regions “have less restrictive laws on abortion, high contraceptive use, high economic development, high levels of gender equality, and well developed health infrastructures”.

Lead author Dr Bela Gunatra, from the WHO, said their work showed “the persistence of inequalities by geography, by income, by levels of development ... that’s the real tragedy that these findings point to.

“Safe abortion is a very safe procedure. It can be provided at primary health care level. It isn’t even necessary that it has to be a procedure. Now you can use tablets. There is nothing that requires this to be highly resourced.

“It is not science that is holding back the progress but barriers in terms of stigma and law.”

In Latin America, where many countries have a ban on abortion in nearly all circumstances, women have resorted to misoprostol, a tablet which they can access online, ideally taken with mifepristone as well.

“It is a very safe method that women are taking into their own hands,” said Gunatra.

If they access the pills through a telemedicine service such as Women on Web which gives them information and support, the study classifies this as safe abortion, she said. But there are large numbers of women obtaining the pills online who do not have help, and those would be less safe.